Providing a secure base for LGBTQ young people in foster care: the role of foster carers

The experiences and needs of lesbian, gay, bisexual, trans and queer / questioning (LGBTQ) young people in care have been overlooked in England, both in policy and research. This article reports on findings from the first study of LGBTQ young people in care in England, and focuses on the nature of foster carers’ experiences and perspectives on caring for LGBTQ young people. Qualitative interviews regarding the fostering role in caring for LGBTQ young people were conducted with a sample of foster carers (n=26) and analysed thematically. Foster carers described the importance of offering LGBTQ young people not only the nurturing relationships that all children in care need, but also availability, sensitivity and acceptance to help young people manage stigma and other challenges associated with minority sexual orientation and gender identity. The Secure Base caregiving model provided a framework for analysing the different dimensions of these relationships. Understanding caregiving roles and relationships for LGBTQ young people in care has important implications for recruiting, training, matching and supporting foster carers to care for LGBTQ young people effectively

A report on the experience of people in receipt of fuel and food vouchers from Norwich Foodbank: A qualitative study

Background: For people on very low incomes, both household fuel and food environments are becoming more uncertain. Many households are in precarious situations, having little control over their lives, including making constant trade-offs between heating and eating. In addition to providing emergency food parcels, Norwich Foodbank also supplies emergency fuel payments. Recently they have seen a major uplift in the need for these. As this is a relatively new service, they need to better understand how people are using the service, and how they might improve what they offer. The brief: The aim of this small qualitative study was to provide independent insights into the experiences of people using fuel and food vouchers at Norwich Foodbank. What we did: We interviewed six people who had been in receipt of fuel and food vouchers between May and November 2022. Main findings: The context of all our interviews were the feelings of overwhelming uncertainty that they experienced. Within this, we identified six key themes from the analysis of our interviews: Accessing the service; Shame; Experience of being a user of the service; Seeking help from other services; Planning and trade-offs and Missing out Suggestions: We identified four recommendations. Firstly, around access to the service, especially for first time users who are in state of denial and shock when they first recognise their need for help with food and fuel. They find it difficult to navigate the system and because they feel guilty about needing to use the service, they don’t like to ask what else they could be entitled to, or what other services are available. Greater clarity in this information would be helpful. Secondly, all our interviews had had acute and complex needs that would have benefited from additional advice. Norwich Foodbank is ideally placed to provide additional support or social prescribing to meet people’s needs in a holistic way. There was a recognition that people were at ‘rock bottom’ before they sought help and that a food parcel or fuel voucher was only a temporary respite and that a follow-up phone call to check up on them and their needs could be really helpful. Finally, advice around cooking with slow cookers and the ingredients in the food parcel and energy saving advice, as people are currently doing this via Google but would appreciate it coming directly from a trustworthy source

Lest we Forget. Illuminating lived experience of the Covid-19 pandemic and lockdown

The Covid-19 pandemic and associated ‘lockdowns’ profoundly impacted people’s lives in 2020 – 2021 and beyond. This study sought to understand unique person-centred insights into health and wellbeing during the restrictive measures in the UK and to enable us to remember and give testimony to these lived experiences. Using photo-methods, participants from a larger cohort study which tracked people’s behaviours during the pandemic were invited to share photographs and short text to visually illustrate their ephemeral and unique Covid-19 experiences. In total 197 participants shared 398 photographs. Using a critical realist approach in our design and analysis, we sought to gain an alternative viewpoint on what ‘lockdown’ and the pandemic meant. Our major findings were starkly contrasting experiences illustrated in our two major themes. Firstly loss, including ambiguous losses and a sense of loss, loss of freedoms and death. Secondly, salutogenesis (what makes us well) whereby participants were able to draw on assets which helped to keep them well by maintaining social connection, ‘making the best of it’, reconnecting with nature and appreciating the outdoors, creativity for pleasure and faith. Our findings illuminate widely differing experiences and indicate the powerful effect of assets that were perceived by our participants to protect their wellbeing. Understanding differential vulnerability will be essential going forward to target resources appropriately to those who have the least control over their lives, those with the greatest vulnerabilities and least assets which in turn could support a self-perpetuating recovery

A pilot e-cigarette voucher scheme in a rural county of the UK

Introduction: E-Cigarette voucher schemes have been piloted across the UK to support populations to quit smoking. This short report evaluates a scheme that targets vulnerable and disadvantaged smokers who had failed to quit smoking by other means. Methods: descriptive summary evaluation of service data on smoking outcomes and qualitative data from selected participants, as ‘key-informants’ (n=4) and key stakeholders (stop smoking staff, vape shop staff and GPs). Results: In total, 668 participants were referred to the scheme, and 340 participants redeemed a voucher. By intention to treat analysis (ITT) 143/668 (21%) were recorded as quit smoking at 4 weeks. At 12 weeks, 7.5% of participants had quit, by ITT. Overall, the pilot project was well received by clients as it offered an affordable route into vaping for smoking cessation. GPs supported the scheme and appreciated being able to offer an alternative to entrenched smokers. Conclusions: The scheme shows promise in supporting entrenched smokers to quit smoking. The offer of similar voucher schemes across the UK suggests potential to reduce overall smoking prevalence and associated morbidity and mortality

Biochemical verification of tobacco-use as an inclusion criterion in smoking cessation trials- Lessons from the Cessation of Smoking Trial in the emergency department

INTRODUCTION: Biochemical verification of smoking status prior to recruitment into smoking cessation trials is widely used to confirm smoking status, most commonly using exhaled carbon monoxide (CO). There is variation in the level of CO used as a biochemical inclusion criterion, and thus the possibility for people reporting to be current smokers to be incorrectly excluded from trials. METHODS: As part of the Cessation of Smoking Trial in the Emergency Department, people attending the Emergency Department (ED) who reported being current daily smokers underwent CO testing to confirm eligibility. Elective semi-structured interviews were undertaken with the researchers who recruited participants. As part of the interviews, researchers were asked their views and experiences with CO testing. RESULTS: Of the 1320 participants who reported being current daily smokers and underwent CO testing, 300 (22.7%) blew a CO reading of 7 ppm or less and were excluded from taking part. Possible explanations offered by researchers for participants blowing low CO readings were (1) long wait times in the ED, therefore a long period having elapsed since people had last smoked and (2) patients having reduced smoking for the period before the ED attendance due to ill health. CONCLUSIONS: Biochemical verification has the potential to improve internal validity of smoking cessation for inclusion in trials, but at the cost of reduced generalisability through exclusion of participants who would receive the intervention if it were implemented in practice. We would recommend researchers carefully consider whether it is appropriate and necessary to include biochemical verification as an inclusion criterio